In the human body, what is a hallux valgus more commonly known as? | febb 1 reply on “In the human body, what is a hallux valgus more commonly known as?” says: Hallux | definition of hallux by Medical dictionary Hallux | definition of hallux by Medical dictionary Related to hallux: hallux limitus hallux [hal´uks] (pl. hal´luces) (L.) the great toe. hallux flex´us hallux rigidus . hallux mal´leus hammer toe affecting the great toe. hallux ri´gidus painful flexion deformity of the great toe with limitation of motion at the metatarsophalangeal joint. hallux val´gus angulation of the great toe toward the other toes of the foot. hallux va´rus angulation of the great toe away from the other toes of the foot. great toe [I] [TA] the first digit of the foot. /hal·lux/ (hal´uks) pl. hal´luces [L.] the great toe. hallux doloro´sus a painful condition of the great toe, usually associated with flatfoot. hallux flex´us h.

rigidus . hallux mal´leus hammer toe affecting the great toe. hallux ri´gidus painful flexion deformity of the great toe with limitation of motion at the metatarsophalangeal joint. hallux val´gus angulation of the great toe toward the other toes. hallux va´rus angulation of the great toe away from the other toes. hallux (hăl′əks) n. pl. halluces (hăl′yə-sēz′, hăl′ə-) 1. The innermost or first digit on the hind foot of certain mammals. The human hallux is commonly called the big toe. 2. A homologous digit of a bird, reptile, or amphibian. In birds, it is often directed backward. hallux Etymology: L, hallex, large toe the great toe. Also spelled hallex. hal·lux The great toe; the first digit of the foot. [a Mod. L. form for L. hallex (hallic-), great toe] hallux The big toe. hallux the first digit on the hind foot of vertebrates, such as the big toe in humans.

hallux the first, great or big toe. hallux rigidus is a stiff and painful toe resulting from osteoarthritis of the metatarsophalangeal joint. In hallux valgus the toe bends at this joint towards the second toe, and the joint bulges from the side of the foot. Can result in permanent displacement (possibly with a degree of external rotation) greater than 10%. Additional friction from poorly fitting footwear can result in a bursa, and the prominence of bone-plus-bursa is known as a bunion . hallux great toe; first toe Want to thank TFD for its existence? Tell a friend about us , add a link to this page, or visit the webmaster's page for free fun content . Link to this page: everted rearfoot References in periodicals archive ?

In brief, mass was measured utilizing a digital scale, tarsus depth was measured with calipers at the midpoint of the tarsus in a front-to-back direction, hallux length was measured as the cord length from the junction of the anterior surface of the talon at the point the claw meets the skin of the toe to the tip of the claw, exposed culmen length was measured with calipers as the cord length between the tip of the beak and the junction of the beak and cere, wing cord was measured with a ruler from the closed wing from the carpal joint to the tip of the longest primary, and tail length was measured with a ruler between the center rectrices from the emergence from the skin to the tip of the longest rectrix (Hull and Bloom 2001). Hallux Rigidus - What is it? Hallux Rigidus Hallux Rigidus Hallux Rigidus Normal big toe x-ray Hallux rigidus describes wear and tear of arthritis (osteo-arthritis) of the great toe. The condition is not particularly related to osteo-arthritis in other areas of the body and in most people it is not related to osteo-arthritic conditions elsewhere in the foot and ankle.

The key features are a stiffening of the movement through the main big toe joint, thickening and bony spur around the joint (particularly noticeable on the top of the foot) and pain from the joint. Pain due to hallux rigidus of the big toe is very variable and may not correspond particularly well to any x-ray or other clinical findings. What symptoms might I get with Hallux Rigidus? Like osteoarthritis in other joints there are a spectrum of presentations. These range from a painless bony "growth" on the top aspect of the big toe Arthritic big toe with osteophyte to discomfort in particular positions of the big toe (especially in higher heels or during "push off" in running when the toe becomes maximally extended). Eventually pain may be present throughout most weight bearing activities or even be present regardless of whether a patient is weight bearing on the foot or not. As with other arthritic conditions the progression of hallux rigidus is unpredictable and may not necessarily occur. What causes Hallux Rigidus ? Most commonly the cause is multifactorial. This means a combination of reasons, partly inherited partly related to previous activities/events.

It can also occur as the end point of an inflammatory arthritis such as rheumatoid arthritis or gout. In most people, however, it is not related to these conditions. Very occasionally it occurs as a direct result of an injury to the joint (big toe MTP joint ). I have a bunion but my toe is also very stiff and painful. It is certainly possible to have a bunion and hallux rigidus at the same time. Usually one is more of a problem than the other. The nature of the surgery is generally decided by which the more prevalent problem is. For example if there were only mild arthritic symptoms with a more painful bunion then a debridement of the joint (a small operation, see below) could be combined with a correction of the hallux valgus. If the arthritic symptoms are more problematic then the main operation should be aimed at this with either a fusion or a modified Kellers/Hamilton operation. These pictures illustrate such a case (in a patient with rheumatoid arthritis as well as lesser toe deformities). The left foot has undergone a fusion of the big toe and correction of the lesser toes.

Hallux Rigidus: Background, Pathophysiology, Etiology Pathophysiology Overview Background Hallux rigidus literally means "stiff great toe"; however, limitation of great-toe motion is only one element of the range of symptoms that constitute the diagnosis of hallux rigidus. Hallux rigidus encompasses mild to severe degenerative arthritis of the first metatarsophalangeal (MTP) joint of the foot. Symptoms can range from mild to disabling. The condition, which occurs in adolescents and adults, can be associated with a history of previous trauma, though many patients present without such a history. This condition was initially described in 1887 by Davies-Colley, who defined hallux flexus as a plantarflexed posture of phalanx relative to the metatarsal (MT) head. [ 1 ] About the same time, Cotterill used the term hallux rigidus, which remains the most common term used to describe the condition in the orthopedic literature. [ 2 , 3 ] Hallux rigidus is a syndrome with symptoms that are related to degenerative arthritis of the great-toe MTP joint.

The symptoms result from cartilage wear, altered joint mechanics, and osteophyte formation, particularly on the dorsal aspect of the first MT head. Hallux rigidus usually causes pain from impingement of dorsal osteophytes, from inflammation, and from shoe-related pressure on prominent osteophytes. It also causes range-of-motion (ROM) pain related to the irregularity of the articular cartilage surface. This condition is seen in two distinct populations: persons who present in adolescence and those who present in adulthood. Nonsurgical measures can often be successfully used to treat patients with varying degrees of severity of hallux rigidus. In patients in whom the condition is refractory to nonoperative treatment methods, the operative options depend on the severity of the degenerative joint disease (DJD). Future advances in addressing hallux rigidus will likely include, through improvements of arthroscopic methods, earlier diagnosis and treatment of lesions involving the symptomatic MTP joint. Early debridement, biologic resurfacing, and the establishment of full ROM may improve the longevity of this joint and minimize the need for joint-destructive methods.

The future development of joint arthroplasty implants and methods may allow joint replacement to be considered as a reliable primary procedure for treatment of severe degenerative arthritis of the great-toe MTP joint. For patient education resources, see Osteoarthritis and Repetitive Motion Injuries . Next: Pathophysiology The pathophysiology of hallux rigidus is similar to that of degenerative arthritis in any joint. Overuse, injury, or abnormal joint mechanics lead to abnormal stresses on the articular cartilage. In an in vitro study, Ahn et al used a magnetic tracking system to monitor the three-dimensional movement of the proximal phalanx while the toe position was changed from a neutral position to full extension. [ 4 ] The contact distribution shifted dorsally with increasing degrees of extension. These data are consistent with the observation that chondral erosions associated with hallux rigidus and degenerative arthritis initially affect the dorsal articular surface of the MT. Articular degenerative changes are associated with dehydration of the cartilage, which, in turn, is more susceptible to injury resulting from shear and compressive forces.

The subchondral bone shares these stresses, which subsequently lead to increased subchondral bone density, formation of periarticular osteophytes, and, in severe cases, cystic changes. The osteophytes limit first MTP joint motion and further compromise the normal mechanics of this joint. This effect can accelerate the degenerative process. In severe cases, the articular cartilage is completely denuded. Previous Next: Etiology The true etiology of hallux rigidus is not known. Most commonly, hallux rigidus is thought to be caused by wear and tear on the first MTP joint. Multiple theories have been proposed for the underlying etiology. Some authors have associated hallux rigidus with athletic activities involving running; in this case, the disorder possibly results from repetitive hyperextension of the first MTP joint with chronic gradual attenuation of the plantar plate and subsequent instability. Hallux rigidus has also been seen as a long-term sequela of acute injuries to the great-toe MTP joint, such as turf toe. Several authors have suggested traumatic injury to the articular cartilage — either acute trauma (as in turf toe ) or chronic, repetitive, minor injury—as the underlying mechanism.

Clanton et al found hallux valgus and early hallux rigidus to be long-term sequelae. After more than 5 years of follow-up, Clanton and Seifert found that among 20 athletes with previous turf-toe injury, half suffered from persistent symptoms. The long-term effects of turf-toe require further study. In 1933, Kingreen reported that osteochondritis dissecans led to development of hallux rigidus. Goodfellow proposed that the development of an osteochondrosis in childhood creates a defect and secondary slow-remodeling collapse, leading to abnormal motion in the forefoot. [ 5 ] McMaster reported on 7 adolescent patients who had an articular defect of approximately 5 mm located directly beneath the dorsal lip of the proximal phalanx; this defect was associated with symptoms of hallux rigidus. [ 6 ] Lambrinudi proposed the so-called metatarsus primus elevatus, in 1938. [ 7 ] Theoretically, an abnormally elevated first MT causes excessive flexion of the great toe during gait and subsequent development of flexion contracture at the first MTP joint. These abnormal mechanics cause hallux rigidus.

Others, such as Jack, in 1940, postulated that with the elevated first MT, increased overload of the second MT occurs, with compensatory contracture of the flexor hallucis brevis (FHB). [ 8 ] This contracture pulls the proximal phalanx inferiorly, driving its dorsal rim into the MT head and leading to localized degenerative changes in the articular cartilage. Hypermobility of the first ray leading to flexor spasm and impingement of the proximal phalanx on the MT head is another proposed theory. [ 9 ] Yet other researchers, such as Jansed, in 1920, have implicated flatfoot . All of these theories are without true scientific data. In 1986, Mann first theorized that a flat first MT head restricts, to a relative extent, the medial and lateral motion of the first MTP joint, creating increased stress in the sagittal plane. This restriction of motion, he said, accelerates the degenerative process. Others have proposed that flattening of the head is a secondary result. [ 10 ] Some authors propose that the disease may develop somewhat differently in adolescents than in adults.

The observation that the first MTP joint returns to normal under anesthesia in adolescents suggests that anatomic anomalies and spasm may be contributing factors. Bingold and Collins suggested that the disease proceeds in stages from adolescence through adulthood. [ 9 ] Vilaseca and Ribes found that a distal physis of the first MT head is present in 75% of children's feet and is visible in children aged 2-11 years. [ 11 ] They also found that the first MT is longer than the second in children who have had a longer persistence of this distal physis. Therefore, individual anatomic variations may play a role in causing functional changes in the MTP motion and position during gait. [ 12 ] An abnormally long first MT (index-plus foot) increases the first MTP joint stress during toe-off, as proposed by Nilsonne in 1930. [ 13 ] This predisposes an individual to hallux rigidus. Nilsonne et al [ 14 ] suggested that the excessively long toe requires a longer shoe, which in turn requires constant contraction of the great-toe flexors to grip the shoe while the person is walking.

This gripping can lead to inflammation and secondary spasm, therefore limiting motion at the MTP joint at the great toe. In a study involving 110 patients with hallux rigidus, Coughlin and Shurnas examined possible associations between the disorder and various physical, health, and lifestyle factors. [ 15 ] The authors saw no association between hallux rigidus and pes planus, first MT length, metatarsus primus elevatus, first-ray hypermobility, hallux valgus, footwear, occupation, obesity, or metatarsus adductus. However, they did see an association between hallux rigidus and hallux valgus interphalangeus (mean 18°), family history (in bilateral cases of hallux rigidus), and trauma (in unilateral cases of the condition). No specific distinction was made between adolescent and adult patients. Previous Next: Epidemiology Hallux rigidus is the second most common disorder of the first MTP joint (with the most common being hallux valgus ). Coughlin and Shurnas reported findings in 110 patients who had undergone surgery for hallux rigidus.

[ 15 ] The authors noted that on final evaluation, about 80% of the patients showed bilateral involvement. In the bilateral cases, 98% of the patients had a positive family history. Although 62% of the patients in Coughlin and Shurnas's report were women, other investigators have reported a slight male predominance. Previous Next: Prognosis Nonsurgical measures can often be used to successfully treat patients with varying degrees of severity of hallux rigidus. In patients in whom the condition is refractory to nonoperative treatment methods, the operative options depend on the severity of the DJD. Waizy et al analyzed long-term clinical outcome and patient satisfaction in 60 patients (20 grade I, 35 grade II, and 5 grade III) with symptomatic hallux rigidus who received joint-preserving operative care. [ 16 ] At follow-up, mean dorsiflexion (DF) increased to about 21.7º in grade I patients, about 23.7º in grade II, and about 26.3º in grade III.

At first follow-up, 100% of grade I patients, 63.3% of grade II patients, and 75% of grade III patients had only occasional pain or no pain at all. At second follow-up, 77.8% of grade I and 73.9% of grade II patients had no pain. Four of the study patients had persistent hypoesthesia of the medial side of the great toe, and three patients had delayed wound healing. No revisions or further surgical procedures were necessary in any of the patients. Tagoe et al followed 33 patients who had undergone total sesamoidectomy for hallux rigidus/limitus (36 procedures) for 2-4 years. [ 17 ] According to the authors, there were high levels of clinical improvement and patient satisfaction following the procedure, with no significant functional impairment or malalignment. There were no instances of pain on metatarsal compression or of transfer metatarsalgia. The authors concluded that for symptomatic patients in whom a joint replacement/fusion is not indicated, total sesamoidectomy may be beneficial as an interim procedure for joints with a moderate degree of arthrosis (grade II to II). Previous Davies-Colley.

Contraction of the metatarso-phalangeal joint of the great toe. BMJ. 1887. 1:728. Cotterill J. Condition of stiff great toe in adolescents. Edinb Med J. 1887. 33:459-62. Cotterill JM. Stiffness of the great toe in adolescents. BMJ. 1988. 1:158. Ahn TK, Kitaoka HB, Luo ZP, et al. Kinematics and contact characteristics of the first metatarsophalangeal joint. Foot Ankle Int. 1997 Mar. 18(3):170-4. [Medline] . Goodfellow J. Aetiology of hallux rigidus. Proc R Soc Med. 1966 Sep. 59(9):821-4. [Medline] . [Full Text] . McMaster MJ. The pathogenesis of hallux rigidus. J Bone Joint Surg Br. 1978 Feb. 60(1):82-7. [Medline] . [Full Text] . Lambrinudi C.

Metatarsus primus elevatus. Proc R Soc Med. 1938. 31:1273. Jack EA. The aetiology of hallux rigidus. Br J Surg. 1940. 27:492-7. Bingold AC, Collins DH. Hallux rigidus. J Bone Joint Surg Br. 1950 May. 32-B(2):214-22. [Medline] . [Full Text] . Mann RA, Clanton TO. Hallux rigidus: treatment by cheilectomy. J Bone Joint Surg Am. 1988 Mar. 70(3):400-6. [Medline] . Vilaseca RR, Ribes ER. The growth of the first metatarsal bone. Foot Ankle. 1980 Sep. 1(2):117-22. [Medline] . Brodsky JW, Baum BS, Pollo FE, et al. Prospective gait analysis in patients with first metatarsophalangeal joint arthrodesis for hallux rigidus. Foot Ankle Int. 2007 Feb.

28(2):162-5. [Medline] . Nilsonne H. Hallux rigidus and its treatment. Acta Orthop Scand. 1930. 1:295-302. Bonney G, Macnab I. Hallux valgus and hallux rigidus; a critical survey of operative results. J Bone Joint Surg Br. 1952 Aug. 34-B(3):366-85. [Medline] . [Full Text] . Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, etiology, and radiographic assessment. Foot Ankle Int. 2003 Oct. 24(10):731-43. [Medline] . Waizy H, Czardybon MA, Stukenborg-Colsman C, Wingenfeld C, Wellmann M, Windhagen H, et al. Mid- and long-term results of the joint preserving therapy of hallux rigidus. Arch Orthop Trauma Surg. 2010 Feb. 130(2):165-70. [Medline] .

Tagoe M, Brown HA, Rees SM. Total sesamoidectomy for painful hallux rigidus: a medium-term outcome study. Foot Ankle Int. 2009 Jul. 30(7):640-6. [Medline] . Lin J, Murphy GA. Treatment of hallux rigidus with cheilectomy using a dorsolateral approach. Foot Ankle Int. 2009 Feb. 30(2):115-9. [Medline] . Can Akgun R, Sahin O, Demirors H, Cengiz Tuncay I. Analysis of modified oblique Keller procedure for severe hallux rigidus. Foot Ankle Int. 2008 Dec. 29(12):1203-8. [Medline] . Konkel KF, Menger AG, Retzlaff SA. Results of metallic Hemi-Great Toe Implant for Grade III and early Grade IV hallux rigidus. Foot Ankle Int. 2009 Jul. 30(7):653-60. [Medline] . Solan MC, Calder JD, Bendall SP.

Manipulation and injection for hallux rigidus. Is it worthwhile?. J Bone Joint Surg Br. 2001 Jul. 83(5):706-8. [Medline] . Zammit GV, Menz HB, Munteanu SE. Structural factors associated with hallux limitus/rigidus: a systematic review of case control studies. J Orthop Sports Phys Ther. 2009 Oct. 39(10):733-42. [Medline] . Erdil M, Elmadag NM, Polat G, Tunçer N, Bilsel K, Uçan V, et al. Comparison of Arthrodesis, Resurfacing Hemiarthroplasty, and Total Joint Replacement in the Treatment of Advanced Hallux Rigidus. J Foot Ankle Surg. 2013 May 6. [Medline] . Mann RA, Coughlin MJ, DuVries HL. Hallux rigidus: a review of the literature and a method of treatment. Clin Orthop. 1979 Jul-Aug. (142):57-63. [Medline] .

Easley ME, Davis WH, Anderson RB. Intermediate to long-term follow-up of medial-approach dorsal cheilectomy for hallux rigidus. Foot Ankle Int. 1999 Mar. 20(3):147-52. [Medline] . Mulier T, Steenwerckx A, Thienpont E, et al. Results after cheilectomy in athletes with hallux rigidus. Foot Ankle Int. 1999 Apr. 20(4):232-7. [Medline] . Mackay DC, Blyth M, Rymaszewski LA. The role of cheilectomy in the treatment of hallux rigidus. J Foot Ankle Surg. 1997 Sep-Oct. 36(5):337-40. [Medline] . Nicolosi N, Hehemann C, Connors J, Boike A. Long-Term Follow-Up of the Cheilectomy for Degenerative Joint Disease of the First Metatarsophalangeal Joint. J Foot Ankle Surg. 2015 May 14. [Medline] .

Kessel L, Bonney G. Hallux rigidus in the adolescent. J Bone Joint Surg Br. 1958 Nov. 40-B(4):669-73. [Medline] . Moberg E. A simple operation for hallux rigidus. Clin Orthop. 1979 Jul-Aug. (142):55-6. [Medline] . Thomas PJ, Smith RW. Proximal phalanx osteotomy for the surgical treatment of hallux rigidus. Foot Ankle Int. 1999 Jan. 20(1):3-12. [Medline] . Citron N, Neil M. Dorsal wedge osteotomy of the proximal phalanx for hallux rigidus. Long-term results. J Bone Joint Surg Br. 1987 Nov. 69(5):835-7. [Medline] . [Full Text] . van Dijk CN, Veenstra KM, Nuesch BC. Arthroscopic surgery of the metatarsophalangeal first joint. Arthroscopy. 1998 Nov-Dec. 14(8):851-5. [Medline] .

Iqbal MJ, Chana GS. Arthroscopic cheilectomy for hallux rigidus. Arthroscopy. 1998 Apr. 14(3):307-10. [Medline] . Roukis TS. Clinical outcomes after isolated periarticular osteotomies of the first metatarsal for hallux rigidus: a systematic review. J Foot Ankle Surg. 2010 Nov-Dec. 49(6):553-60. [Medline] . Hunt KJ, Anderson RB. Biplanar proximal phalanx closing wedge osteotomy for hallux rigidus. Foot Ankle Int. 2012 Dec. 33(12):1043-50. [Medline] . Conti SF, Dhawan S. Arthrodesis of the first metatarsophalangeal and interphalangeal joints of the foot. Foot Ankle Clin. 1996. 1:33-53. Harper MC. Positioning of the hallux for first metatarsophalangeal joint arthrodesis. Foot Ankle Int. 1997 Dec.

18(12):827. [Medline] . Coughlin MJ, Abdo RV. Arthrodesis of the first metatarsophalangeal joint with Vitallium plate fixation. Foot Ankle Int. 1994 Jan. 15(1):18-28. [Medline] . Curtis MJ, Myerson M, Jinnah RH. Arthrodesis of the first metatarsophalangeal joint: a biomechanical study of internal fixation techniques. Foot Ankle. 1993 Sep. 14(7):395-9. [Medline] . Coughlin MJ, Mann RA. Arthrodesis of the first metatarsophalangeal joint as salvage for the failed Keller procedure. J Bone Joint Surg Am. 1987 Jan. 69(1):68-75. [Medline] . Smith RW, Joanis TL, Maxwell PD. Great toe metatarsophalangeal joint arthrodesis: a user-friendly technique. Foot Ankle. 1992 Sep. 13(7):367-77. [Medline] .

Hamilton WG, O'Malley MJ, Thompson FM, et al. Roger Mann Award 1995. Capsular interposition arthroplasty for severe hallux rigidus. Foot Ankle Int. 1997 Feb. 18(2):68-70. [Medline] . Kennedy MP, Coughlin MJ. Peg-in-socket arthrodesis of the first metatarsophalangeal joint. Foot Ankle Int. 2002 Apr. 23(4):352-4. [Medline] . DeFrino PF, Brodsky JW, Pollo FE, et al. First metatarsophalangeal arthrodesis: a clinical, pedobarographic and gait analysis study. Foot Ankle Int. 2002 Jun. 23(6):496-502. [Medline] . Hahn MP, Gerhardt N, Thordarson DB. Medial capsular interpositional arthroplasty for severe hallux rigidus. Foot Ankle Int. 2009 Jun. 30(6):494-9. [Medline] .

Lau JT, Daniels TR. Outcomes following cheilectomy and interpositional arthroplasty in hallux rigidus. Foot Ankle Int. 2001 Jun. 22(6):462-70. [Medline] . Cracchiolo A 3rd, Weltmer JB Jr, Lian G. Arthroplasty of the first metatarsophalangeal joint with a double-stem silicone implant. Results in patients who have degenerative joint disease failure of previous operations, or rheumatoid arthritis. J Bone Joint Surg Am. 1992 Apr. 74(4):552-63. [Medline] . Shereff MJ, Jahss MH. Complications of silastic implant arthroplasty in the hallux. Foot Ankle. 1980 Sep. 1(2):95-101. [Medline] . Shiel WC Jr, Jason M. Granulomatous inguinal lymphadenopathy after bilateral metatarsophalangeal joint silicone arthroplasty. Foot Ankle. 1986 Apr. 6(5):216-8. [Medline] .

Verhaar J, Vermeulen A, Bulstra S. Bone reaction to silicone metatarsophalangeal joint-1 hemiprosthesis. Clin Orthop. 1989 Aug. (245):228-32. [Medline] . Rahman H, Fagg PS. Silicone granulomatous reactions after first metatarsophalangeal hemiarthroplasty. J Bone Joint Surg Br. 1993 Jul. 75(4):637-9. [Medline] . [Full Text] . Shankar NS. Silastic single-stem implants in the treatment of hallux rigidus. Foot Ankle Int. 1995 Aug. 16(8):487-91. [Medline] . Townley CO, Taranow WS. A metallic hemiarthroplasty resurfacing prosthesis for the hallux metatarsophalangeal joint. Foot Ankle Int. 1994 Nov. 15(11):575-80. [Medline] . Johnson KA, Buck PG. Total replacement arthroplasty of the first metatarsophalangeal joint.

Foot Ankle. 1981 May. 1(6):307-14. [Medline] . Lu HS, Kou BL, Yuan YL. [Follow-up result of 14 cases of the first metatarsophalangeal joint arthroplasty with titanium total joint prostheses]. Zhonghua Wai Ke Za Zhi. 1994 Sep. 32(9):542-4. [Medline] . Gheorghiu D, Coles C, Ballester J. Hemiarthroplasty for Hallux Rigidus: Mid-Term Results. J Foot Ankle Surg. 2015 Jul-Aug. 54 (4):591-3. [Medline] . Barca F. Tendon arthroplasty of the first metatarsophalangeal joint in hallux rigidus: preliminary communication. Foot Ankle Int. 1997 Apr. 18(4):222-8. [Medline] . Cavolo DJ, Cavallaro DC, Arrington LE. The Watermann osteotomy for hallux limitus. J Am Podiatry Assoc. 1979 Jan.

69(1):52-7. [Medline] . Coughlin M. Arthritides. Coughlin M, Mann R, eds. Surgery of the Foot & Ankle. 7th ed. St Louis, Mo: Mosby; 1999. 605-50. Deheer PA. The case against first metatarsal phalangeal joint implant arthroplasty. Clin Podiatr Med Surg. 2006 Oct. 23(4):709-23, vi. [Medline] . Feltham GT, Hanks SE, Marcus RE. Age-based outcomes of cheilectomy for the treatment of hallux rigidus. Foot Ankle Int. 2001 Mar. 22(3):192-7. [Medline] . Ghalambor N, Cho DR, Goldring SR, et al. Microscopic metallic wear and tissue response in failed titanium hallux metatarsophalangeal implants: two cases. Foot Ankle Int. 2002 Feb. 23(2):158-62. [Medline] . Hamilton WG, Hubbard CE.

Hallux rigidus. Excisional arthroplasty. Foot Ankle Clin. 2000 Sep. 5(3):663-71. [Medline] . Horton GA, Park YW, Myerson MS. Role of metatarsus primus elevatus in the pathogenesis of hallux rigidus. Foot Ankle Int. 1999 Dec. 20(12):777-80. [Medline] . Sammarco GJ, Tabatowski K. Silicone lymphadenopathy associated with failed prosthesis of the hallux: a case report and literature review. Foot Ankle. 1992 Jun. 13(5):273-6. [Medline] . Sebold EJ, Cracchiolo A 3rd. Use of titanium grommets in silicone implant arthroplasty of the hallux metatarsophalangeal joint. Foot Ankle Int. 1996 Mar. 17(3):145-51. [Medline] . Trnka HJ. Arthrodesis procedures for salvage of the hallux metatarsophalangeal joint.

Foot Ankle Clin. 2000 Sep. 5(3):673-86, ix. [Medline] . Media Gallery A patient who presented with a tender, palpable dorsal osteophyte at the first metatarsophalangeal joint on physical exam. A patient who presented with a tender, palpable dorsal osteophyte at the first metatarsophalangeal joint on physical exam. Dorsal exostoses base of proximal phalanx and first metatarsal head blocking dorsiflexion and causing impingement. Joint-space narrowing, marginal osteophytes, and irregularity of the first metatarsal phalangeal joint. Status post cheilectomy, first metatarsal phalangeal joint with excision of the dorsal aspect of the first metatarsal head. Arthrodesis of first metatarsal phalangeal joint using 2 crossed screws. Severe arthrosis first metatarsal phalangeal joint and bony changes of the metatarsal head and the proximal phalanx seen during arthrodiastasis first metatarsal phalangeal joint.

Arthrodiastasis first metatarsal phalangeal joint using a mini external fixator. of 8 Valgus - definition of valgus by The Free Dictionary Valgus - definition of valgus by The Free Dictionary (văl′gəs) adj. 1. Characterized by an abnormal outward turning of a bone, especially of the hip, knee, or foot. 2. Knock-kneed. (ˈvælɡəs) adj (Pathology) pathol denoting a deformity in which the distal part of a limb is displaced or twisted away from the midline of the body. See hallux valgus [C19: from Latin: knock-kneed] n., pl. -gus•es, adj. n. 1. an abnormally turned position of a part of the bone structure of a human being, esp. of the leg. adj. [1790–1800; < Latin] valgus 1. an abnormally turned condition of a bone in part of the human body, especially the leg. 2. the condition of being bow-legged. See also: Body, Human 1.

an abnormally turned condition of a bone in part of the human body, especially the leg. 2. the condition of being bowlegged. Noun 1. valgus - a deformity in which there is an abnormal displacement of part of a limb away from the midline of the body deformity , malformation , misshapenness - an affliction in which some part of the body is misshapen or malformed varus - a deformity in which part of a limb is turned inward to an abnormal degree Translations valgus adj valgo, desviado hacia afuera (refiriéndose a una extremidad o parte de ella en relación con el eje del cuerpo) What are the common types of surgery and how are they performed? | Arthritis Research UK Back to Foot and ankle surgery Bunions Bunions are bony lumps that develop on the side of your foot and at the base of your big toe. They’re the result of a condition called hallux valgus, which causes your big toe joint to bend towards the other toes and become deformed. If symptoms carry on over a long period, your toe may need to be surgically corrected.

This involves straightening your big toe and metatarsals, a process called an osteotomy. Although this may make your joint stiffer, it works to ease the pain. Most surgery can be performed as a day case and takes up to an hour. Your foot will be bandaged and you’ll need to wear a Velcro surgical shoe for four to six weeks afterwards. If your bunion has been caused by rheumatoid arthritis , you may also develop rheumatoid nodules. These firm, pea-sized lumps can occur at pressure points such as your big toe joints, the back of your heels or on your toes, but they can be surgically removed. Sometimes swellings or bursae on the joints in your feet are also called bunions, but these aren’t the same as bunions caused by hallux valgus and don’t need surgery. Hallux valgus is different to hallux rigidus, which is osteoarthritis of the big toe joint. Hallux rigidus causes stiffness in your big toe and you won’t be able to move it as far. If treated early, surgery can be used to remove painful osteophytes (overgrowth of new bone) that can develop and allow more joint movement to return.

In more advanced cases, fusion surgery (joining bones together to make one stiff bone where there two) gives excellent pain relief, although it will mean that the joint will no longer bend when you walk so you won’t be able to wear high-heeled shoes. Hammer toes As well as bunions, hallux valgus can also cause your other toes to become clawed or permanently bent. This condition is known as hammer toes. Damages caused by hammer toes can be eased by: arthroplasty – removing the deformed joint between your toe bones (phalanges), which leaves the joint flexible arthrodesis – fusing your phalanges together, which leaves your toe more stable but means you’ll only be able to wear flat shoes after the operation. Both procedures are performed as day cases and last around an hour. Your stitches will be removed about two to three weeks following surgery and you’ll need another dressing for two to six weeks after that. You should limit how much you walk for the first three days. Metatarsal surgery The joints in your forefoot can be damaged by inflammation of the lining of your joint (synovitis) in some forms of arthritis, for example rheumatoid arthritis.

These small joints are called the metatarsophalangeal joints (MTPJs), and they can become dislocated when damaged by arthritis. The pain and discomfort this causes is sometimes described as feeling like you’re walking on pebbles. If your symptoms are severe and can’t be controlled by other treatment, you may need surgery. The exact surgical procedure and the follow-up you’ll need will depend on how severe the problem is, but often surgery to your big toe and removal of the heads of your MTPJs is carried out in order to make your foot more comfortable and walking easier. Your surgeon will be able to give you more information before the operation. Ankle arthritis Ankle arthritis is usually caused by osteoarthritis. This is where the cartilage covering the ends of your bones gradually roughens and becomes thin, and the bone underneath thickens. It can also be caused by damage from other rheumatic conditions, for example if you have rheumatoid arthritis, or if you’ve had a previous injury to the area. This leads to pain, swelling and occasional deformity of the joint. You may need surgery if your symptoms are severe.

There are three surgical options: Ankle fusion – Ankle fusion involves removing the damaged ankle joint and fusing your talus bone to your tibia to form a stiff but pain-free ankle. Your foot is fused at a right angle to your leg, in the position it would be if you were standing up. Your bones are held together using screws and new bone grows across, creating one bone where there were two. It normally takes between 12–14 weeks for the fusion to be complete and your bone continues to become stronger after this. In some cases this procedure can be performed using keyhole surgery (arthroscopy), which means it can be done through just a small cut, so your joint doesn’t have to be opened up. The procedure takes between one and two hours. After surgery you’ll need to wear a cast for 6–12 weeks, depending on your situation. You should be able to wear normal shoes after the cast is removed, although some alterations are occasionally needed. It should be easier to walk normally or even more comfortably than you did before surgery if your other joints aren’t affected by arthritis, but running isn’t recommended.

Triple fusion – Triple fusion is the surgical fusion of three joints (the talonavicular, subtalar and calcaneocuboid joints) either as a treatment for arthritis within these joints or as a method of correcting a stiff foot deformity. A combination of plates, screws or staples is often used to do this. It takes 12–14 weeks for the fusion to be complete. Ankle replacement – An ankle replacement involves taking out the worn-out ends of your tibia and talus bones and replacing them with aman-made (artificial) ends made out of plastic or metal. Unlike an ankle fusion, a replacement allows you to move your joint after surgery. The procedure takes between one and two hours and you’ll normally need to stay in hospital for two days. Your foot will be put in a temporary cast afterwards but then it’ll be bandaged and you may need a splint for support. This allows you to move it fairly soon after surgery, but you’ll probably need to use crutches for about six weeks. Replacement ankle joints haven’t been used for as long as replacement hips and knees, and they don’t last as long, but they can last for about 10–15 years.

Your occupational therapist or physiotherapist will advise you on how to take care of the new joint. As with all joint replacements, there’s a chance that your new joint will wear away over time and you may need to have it removed to have ankle fusion surgery. Fusion after a replacement is harder to do than a primary fusion and more bone may need to be removed. You may need a bone graft (where bone is taken from elsewhere in your body, normally your pelvis) to replace the removed bone. This is quite a common procedure, and ankle fusion following a replacement is usually very successful. Arthritis Research UK have recently awarded a grant for the OARS study , which will assess the major factors that predict what patients think (patient-reported outcome) in the first year after total ankle replacement. Achilles tendon disorders Your Achilles tendon is the largest tendon in your body,and the muscle in your lower leg puts a lot of force through it to make you move. As we get older it can start to wear, which can lead to painful swellings within the main tendon or where it attaches to your heel bone. Very occasionally surgery can be used as a method of treatment.

This procedure is usually performed as a day case and you’ll need to wear a bandage and use crutches afterwards. Morton’s neuroma Morton’s neuroma is a painful condition that involves a nerve that supplies feeling to two neighbouring toes. It most commonly affects the nerve to your third and fourth toes. If your symptoms are bad, surgery to remove the painful nerve can be successful. This can be done as a day case and you’ll need to wear a bandage for two weeks afterwards. Tibialis posterior dysfunction The tibialis posterior is a muscle that supports the shape of your instep arch. The tendon that connects this muscle to the bone can become inflamed, leading to pain and swelling on the inside of your ankle. Continual swelling can start to cause the tendon to weaken, which can lead to a flatfooted look. Occasionally, bad cases need surgery to rebuild the instep arch. If your case is long-standing or you haven’t had treatment, three of your hindfoot joints may need to be fused (triple fusion) to ease pain. Both operations take between one and two hours and you’ll need to wear a plaster cast for 6–12 weeks after.

Plantar fasciitis The plantar fascia is a tough band of fibrous tissue that starts at your heel bone and stretches across the sole of your foot to your toes. Plantar fasciitis is inflammation at the site where the fascia attaches under your heel. Very rarely, bad cases may need surgery to release the plantar fascia from the heel bone. This procedure is usually performed as a day case and it takes less than an hour. You’ll only need to wear a bandage after the operation. Hallux Valgus: Background, Anatomy, Pathophysiology Pathophysiology Hallux valgus is considered to involve the following: Medial deviation of the first metatarsal Lateral deviation and/or rotation of the hallux Prominence, with or without medial soft-tissue enlargement of the first metatarsal head This condition can lead to painful motion of the joint and difficulty with footwear. In the 19th century, the prevalent understanding of the bunion—hallux valgus—was that it was purely an enlargement of the soft tissue, first metatarsal head, or both, most commonly caused by ill-fitting footwear.

Thus, treatment had varying results, with controversy over whether to remove the overlying bursa alone or in combination with an exostectomy of the medial head. Because many surgeons considered these surgeries to be beneath them, a fuller understanding of the pathology of hallux valgus was slow to develop. Gradually, surgeons began to recognize that bunions could develop as a result of numerous different factors, that they tended to be familial, and that they often were associated with other foot deformities. The first surgical treatment to address this deforming pathology was described by Reverdin on May 4, 1881, in a report delivered to the Medical Society of Genfer. In this procedure, a curved incision medial to the extensor hallucis longus was followed by incision of the periosteum, chiseling off of the exostosis, removal of a wedge of bone from behind the capitulum of the metatarsus, and suturing of the bone with catgut. This operation is the forerunner of all operations that aim to correct hallux valgus via osteotomy.

Since its inception, the Reverdin procedure has undergone many variations and modifications, including the addition of lateral releases and proximal osteotomies, in an effort to address deformity. Indeed, more than 100 procedures have been developed for the correction of hallux valgus. However, many were developed out of ignorance; some are even repetitions of previous procedures, with inconsistent rates of failure and success. Surgeons continue to reevaluate osteotomy for the treatment of hallux valgus to determine the most stable procedure with the fewest complications. Next: Anatomy Effective treatment of hallux valgus depends on a solid understanding of the anatomy involved (see the images below). Lateral view of first metatarsophalangeal joint with ligaments of sesamoid complex. Next: Pathophysiology During the gait cycle, the hallux and digits generally remain parallel to the long axis of the foot, regardless of the degree of forefoot abduction (or pronation) occurring (see the image below). This is because of the pull of the conjoined adductor tendon, extensor hallucis longus, and flexor hallucis longus tendons.

The tendons gain greater mechanical advantage the further the joint is displaced, with tension created in the medial aspect of the joint and compression laterally. Line of pull of extensor hallucis longus causing metatarsal to deviate medially and hallux to deviate laterally. View Media Gallery Medial tension causes the medial collateral ligaments to pull on the dorsomedial aspect of the first metatarsal head, causing bone proliferation. Lateral tension causes the sesamoid apparatus to fixate in a laterally dislocated position. Remodeling also occurs laterally in addition to medially, as evidenced by the increase of the proximal articular set angle or structural remodeling of the cartilage. Therefore, without correction of the biomechanical factors, excessive pronation continues, with propagation of the deformity. Previous Next: Etiology Contrary to common belief, high-heeled shoes with a small toe box or tight-fitting shoes do not cause hallux valgus. However, such footwear does keep the hallux in an abducted position if hallux valgus is present, causing mechanical stretch and deviation of the medial soft tissue and aggravating symptoms. In addition, tight shoes can cause medial bump pain and nerve entrapment.

Hallux valgus is known to have numerous etiologies, including biomechanical, traumatic, and metabolic factors. The most common yet most difficult to understand etiology of hallux valgus is biomechanical instability. Contributing factors, if present, include gastrocnemius or gastrocnemius-soleus equinus, flexible or rigid pes planovalgus, rigid or flexible forefoot varus, dorsiflexed first ray, hypermobility, or short first metatarsal. Most often, excessive pronation at the midtarsal and subtalar joints compensates for these factors throughout the gait cycle. Some pronation must occur in gait to absorb ground-reactive forces. However, excessive pronation produces too much midfoot mobility, which decreases stability and prevents resupination and creation of a rigid lever arm; these effects make propulsion difficult. During normal propulsion, approximately 65° of dorsiflexion is necessary at the first metatarsophalangeal (MTP) joint, yet only 20-30° is available from hallux dorsiflexion.

Therefore, the first metatarsal must plantarflex at the sesamoid complex to gain the additional 40° of motion needed. Failure to attain the full 65° because of jamming of the joint during pronation subjects the first MTP to intense forces from which hallux valgus can develop. If the foot is sufficiently hypermobile as a result of excessive pronation, the metatarsal tends to drift medially and the hallux drifts laterally, producing hallux valgus. If no hypermobility is present, hallux rigidus develops instead. Arthritic/metabolic conditions that may cause hallux valgus include inflammatory arthropathies such as gouty arthritis , rheumatoid arthritis (see the images below), and psoriatic arthritis , as well as connective tissue disorders such as Ehlers-Danlos syndrome , Marfan syndrome , Down syndrome , and generalized ligamentous laxity. Rheumatoid arthritis. Note greater deformity of right foot (image left) versus left foot (image right). The myriad neuromuscular diseases that may cause hallux valgus include multiple sclerosis , Charcot-Marie-Tooth disease , and cerebral palsy .

Traumatic conditions that may cause hallux valgus include malunions with or without intra-articular damage, soft-tissue injuries of the hallux, and sequelae of dislocations. Structural deformities that have been associated with hallux valgus include malalignment of articular surface or metatarsal shaft, abnormal metatarsal length, metatarsus primus elevatus, external tibial torsion, genu varum or valgum , and femoral retrotorsion. Previous Next: Epidemiology Although hallux valgus is a common condition that accounts for a significant number of office visits to foot and ankle specialists, the incidence has not been documented accurately. Relatively few studies are available, and much of the information consists of empirical data with low levels of evidence. According to the National Health Interview survey conducted by the National Center for Health Statistics, this condition affects 1% of adults in the United States. Gould et al found that the incidence increased proportionately with age, from 3% in persons aged 15-30 years to 9% in persons aged 31-60 years to 16% in those older than 60 years.

Gould et al also reported a two- to fourfold higher incidence in females than in males. Whether this finding indicates a true sex-based dimorphism or whether it reflects differences in footwear remains to be determined. The role of genetic predisposition has also been noted, with evidence to suggest familial tendencies. No conclusive results have been reported to indicate racial or ethnic predisposition. Previous Next: Prognosis Hallux valgus is a complex deformity, and various approaches are available. To date, no satisfactory studies have been performed to compare the various procedures and their success rates. If the deformity and etiology are addressed successfully, the benefits of treatment far outweigh the risks. [ 1 , 2 ] Schuh et al studied changes of plantar pressure distribution during the stance phase of gait in patients who underwent hallux valgus surgery followed by multimodal rehabilitation. The study included 30 patients who underwent Austin and scarf osteotomy for correction of mild-to-moderate hallux valgus deformity and began a rehabilitation program 4 weeks postoperatively (once weekly for 4-6 weeks).

[ 3 ] Plantar pressure analysis was performed preoperatively and at 4 weeks, 8 weeks, and 6 months postoperatively. ROM of the first MTP joint was also measured. [ 3 ] The results of this study included an increased mean American Orthopaedic Foot and Ankle Society (AOFAS) score, from 60.7 points preoperatively to 94.5 points 6 months after surgery, and the first MTP joint ROM increased at 6 months, with a significant increase in isolated dorsiflexion. [ 3 ] In the first metatarsal head region, maximum force increased from 117.8 N to 126.4 N, and the force-time integral increased from 37.9 N⋅s to 55.6 N⋅s. In the great toe region, maximum force increased from 66.1 N to 87.2 N, and the force-time integral increased from 18.7 N⋅s to 24.2 N⋅s. Previous References Mann RA, Rudicel S, Graves SC.

Repair of hallux valgus with a distal soft-tissue procedure and proximal metatarsal osteotomy. A long-term follow-up. J Bone Joint Surg Am. 1992 Jan. 74(1):124-9. [Medline] . Pressman MM, Stano GW, Krantz MK, Novicki DC. Correction of hallux valgus with positionally increased intermetatarsal angle. J Am Podiatr Med Assoc. 1986 Nov. 76(11):611-6. [Medline] . Schuh R, Hofstaetter SG, Adams SB Jr, Pichler F, Kristen KH, Trnka HJ. Rehabilitation after hallux valgus surgery: importance of physical therapy to restore weight bearing of the first ray during the stance phase. Phys Ther. 2009 Sep. 89(9):934-45. [Medline] . Stewart S, Dalbeth N, Vandal AC, Rome K. The first metatarsophalangeal joint in gout: a systematic review and meta-analysis. BMC Musculoskelet Disord.

2016 Feb 11. 17:69. [Medline] . Glasoe WM, Jensen DD, Kampa BB, Karg LK, Krych AR, Pena FA, et al. First ray kinematics in women with rheumatoid arthritis and bunion deformity: a gait simulation imaging study. Arthritis Care Res (Hoboken). 2014 Jun. 66 (6):837-43. [Medline] . Palestro CJ. Continuing Education on Radionuclide Imaging of Musculoskeletal Infection: A Review. J Nucl Med. 2016 Jul 7. [Medline] . Favinger JL, Porrino JA, Richardson ML, Mulcahy H, Chew FS, Brage ME. Epidemiology and imaging appearance of the normal Bi-/multipartite hallux sesamoid bone. Foot Ankle Int. 2015 Feb. 36 (2):197-202. [Medline] . Collan L, Kankare JA, Mattila K.

The biomechanics of the first metatarsal bone in hallux valgus: a preliminary study utilizing a weight bearing extremity CT. Foot Ankle Surg. 2013 Sep. 19 (3):155-61. [Medline] . Smith BW, Coughlin MJ. Treatment of hallux valgus with increased distal metatarsal articular angle: use of double and triple osteotomies. Foot Ankle Clin. 2009 Sep. 14(3):369-82. [Medline] . Shima H, Okuda R, Yasuda T, Jotoku T, Kitano N, Kinoshita M. Radiographic measurements in patients with hallux valgus before and after proximal crescentic osteotomy. J Bone Joint Surg Am. 2009 Jun. 91(6):1369-76. [Medline] . Doty JF, Coughlin MJ, Hirose C, Stevens F, Schutt S, Kennedy M, et al. First metatarsocuneiform joint mobility: radiographic, anatomic, and clinical characteristics of the articular surface. Foot Ankle Int.

2014 May. 35 (5):504-11. [Medline] . Root ML, Orien WP, Weed JH. Normal and Abnormal Function of the Foot. Vol 2. Los Angeles, Calif: Clinical Biomechanics; 1977. Karabicak GO, Bek N, Tiftikci U. Short-Term Effects of Kinesiotaping on Pain and Joint Alignment in Conservative Treatment of Hallux Valgus. J Manipulative Physiol Ther. 2015 Oct. 38 (8):564-71. [Medline] . Hawke F, Burns J, Radford JA, du Toit V. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database Syst Rev. 2008 Jul 16. CD006801. [Medline] . Doty JF, Alvarez RG, Ervin TB, Heard A, Gilbreath J, Richardson NS. Biomechanical Evaluation of Custom Foot Orthoses for Hallux Valgus Deformity. J Foot Ankle Surg. 2015 Sep-Oct.

54 (5):852-5. [Medline] . Farzadi M, Safaeepour Z, Mousavi ME, Saeedi H. Effect of medial arch support foot orthosis on plantar pressure distribution in females with mild-to-moderate hallux valgus after one month of follow-up. Prosthet Orthot Int. 2015 Apr. 39 (2):134-9. [Medline] . Reina M, Lafuente G, Munuera PV. Effect of custom-made foot orthoses in female hallux valgus after one-year follow up. Prosthet Orthot Int. 2013 Apr. 37 (2):113-9. [Medline] . Cancilleri F, Marinozzi A, Martinelli N, Ippolito M, Spiezia F, Ronconi P, et al. Comparison of plantar pressure, clinical, and radiographic changes of the forefoot after biplanar austin osteotomy and triplanar boc osteotomy in patients with mild hallux valgus. Foot Ankle Int. 2008 Aug.

29(8):817-24. [Medline] . Lagaay PM, Hamilton GA, Ford LA, Williams ME, Rush SM, Schuberth JM. Rates of revision surgery using chevron-Austin osteotomy, Lapidus arthrodesis, and closing base wedge osteotomy for correction of hallux valgus deformity. J Foot Ankle Surg. 2008 Jul-Aug. 47(4):267-72. [Medline] . McCarthy AD, Davies MB, Wembridge KR, Blundell C. Three-dimensional analysis of different first metatarsal osteotomies in a hallux valgus model. Foot Ankle Int. 2008 Jun. 29(6):606-12. [Medline] . Grawe B, Parikh S, Crawford A, Tamai J. Hallux valgus interphalangeus deformity: A case series in the pediatric population. Foot Ankle Surg. 2012 Mar. 18(1):e4-8. [Medline] . Lui TH, Chan KB.

Technical tip: Reconstruction of medial collateral ligament in correction of hallux valgus deformity with primary medial collateral ligamentous insufficiency. Foot Ankle Surg. 2012 Mar. 18(1):66-73. [Medline] . Elliot RR, Saxby TS, Whitehouse SL. Intraoperative imaging in hallux valgus surgery. Foot Ankle Surg. 2012 Mar. 18(1):19-21. [Medline] . Unver B, Sampiyon O, Karatosun V, Gunal I, Angin S. Postoperative immobilisation orthosis for surgically corrected hallux valgus. Prosthet Orthot Int. 2004 Dec. 28 (3):278-80. [Medline] . Lui TH, Chan KB, Chow HT, Ma CM, Chan PK, Ngai WK. Arthroscopy-assisted correction of hallux valgus deformity. Arthroscopy. 2008 Aug. 24 (8):875-80. [Medline] . Donatto KC, Rightor N, D'Ambrosia R.

Custom-molded orthotics in postoperative hallux valgus immobilization. Orthopedics. 1992 Apr. 15 (4):449-51. [Medline] . Lin YC, Cheng YM, Chang JK, Chen CH, Huang PJ. Minimally Invasive Distal Metatarsal Osteotomy for Mild-to-moderate Hallux Valgus Deformity. Kaohsiung J Med Sci. 2009 Aug. 25(8):431-7. [Medline] . Shibuya N, Thorud JC, Martin LR, Plemmons BS, Jupiter DC. Evaluation of Hallux Valgus Correction With Versus Without Akin Proximal Phalanx Osteotomy. J Foot Ankle Surg. 2016 Jun 8. [Medline] . Yañez Arauz JM, Del Vecchio JJ, Codesido M, Raimondi N. Minimally invasive Akin osteotomy and lateral release: Anatomical structures at risk-A cadaveric study. Foot (Edinb). 2016 Jun. 27:32-5. [Medline] .

Buciuto R. Prospective Randomized Study of Chevron Osteotomy Versus Mitchell's Osteotomy in Hallux Valgus. Foot Ankle Int. 2014 Sep 10. [Medline] . Poggio D, Melo R, Botello J, Polo C, Fernández de Retana P, Asunción J. Comparison of postoperative costs of two surgical techniques for hallux valgus (Kramer vs. scarf). Foot Ankle Surg. 2015 Mar. 21 (1):37-41. [Medline] . Garrido IM, Rubio ER, Bosch MN, González MS, Paz GB, Llabrés AJ. Scarf and Akin osteotomies for moderate and severe hallux valgus: clinical and radiographic results. Foot Ankle Surg. 2008. 14 (4):194-203. [Medline] . Matsumoto T, Kadono Y, Nishino J, Nakamura K, Tanaka S, Yasui T.

Midterm results of resection arthroplasty for forefoot deformities in patients with rheumatoid arthritis and the risk factors associated with patient dissatisfaction. J Foot Ankle Surg. 2014 Jan-Feb. 53 (1):41-6. [Medline] . Putti AB, Pande S, Adam RF, Abboud RJ. Keller's arthroplasty in adults with hallux valgus and hallux rigidus. Foot Ankle Surg. 2012 Mar. 18 (1):34-8. [Medline] . Fleming JJ, Kwaadu KY, Brinkley JC, Ozuzu Y. Intraoperative evaluation of medial intercuneiform instability after Lapidus arthrodesis: intercuneiform hook test. J Foot Ankle Surg. 2015 May-Jun. 54 (3):464-72. [Medline] . Mouton A, Le Strat V, Medevielle D, Kerroumi Y, Graff W, French association of foot surgery (AFCP). Patient's satisfaction after outpatient forefoot surgery: Study of 619 cases.

Orthop Traumatol Surg Res. 2015 Oct. 101 (6 Suppl):S217-20. [Medline] . Gądek A, Liszka H, Wordliczek J. Postoperative pain and preemptive local anesthetic infiltration in hallux valgus surgery. Foot Ankle Int. 2015 Mar. 36 (3):277-81. [Medline] . Matricali GA, Vermeersch G, Busschots E, Fieuws S, Deschamps K. Prospective randomized comparative study on V-Y and pants-over-vest capsulorraphy in chevron and scarf osteotomy. Acta Orthop Belg. 2014 Jun. 80(2):280-7. [Medline] . Banks AS. Avascular necrosis of the first metatarsal head. A different perspective. J Am Podiatr Med Assoc. 1999 Sep. 89(9):441-53. [Medline] . Conklin MJ. Complications of hallux valgus surgery. Foot Ankle Clin. 1998.

3:19-31. Vianna VF, Myerson MS. Complications of hallux valgus surgery: Management of the short first metatarsal and the failed resection arthroplasty. Foot Ankle Clin. 1998. 3:33-49. Duan X, Kadakia AR. Salvage of recurrence after failed surgical treatment of hallux valgus. Arch Orthop Trauma Surg. 2011 Dec 29. [Medline] . Ferrari J. Bunions. Clin Evid (Online). 2009 Mar 11. 2009: [Medline] . Media Gallery Rheumatoid arthritis. Note greater deformity of right foot (image left) versus left foot (image right). Rheumatoid arthritis. Note lateral deviation of hallux, cystic changes of metatarsal head, and hammertoe of lesser digits. Line of pull of extensor hallucis longus causing metatarsal to deviate medially and hallux to deviate laterally. Nonweightbearing foot. Note medial prominence, contracture of extensor hallucis longus, and callus on second digit.

Nonweightbearing foot with range of motion being assessed of first ray, which is currently in neutral (neither plantarflexed or dorsiflexed) position. Lateral view of first metatarsophalangeal joint with ligaments of sesamoid complex. Plantar muscles that contribute to deforming forces. Anteroposterior and lateral radiographs, weightbearing views. Medial bony enlargement is more prominent on this lateral oblique projection than on other views. Template showing angular measurements. Another template showing increased angular relationships. Congruency of first metatarsophalangeal joint. Tibial sesamoid position with bisection of first metatarsal. Positions 1-3 are normal. Positions 4-7 indicate erosion of crista and laterally track-bound, nonreducible hallux valgus. Bunion deformity with minimal joint destruction. Bunion deformity with significant joint destruction. Large intermetatarsal angle and hallux abductovalgus deformity secondary to previous injury. Note increased cortical density of second, third, and fourth metatarsals. Algorithm for choosing surgical correction of hallux abductovalgus. Click image to enlarge. Hallux abductovalgus deformity.

Postoperative radiograph obtained after head osteotomy. Preoperative radiograph. Postoperative radiograph shows Keller, or resectional, arthroplasty. Preoperative radiograph shows degenerative joint disease. Postoperative radiograph obtained after resectional arthroplasty and total joint implant placement. Preoperative template for implant placement. Preoperative radiograph shows arthrodesis. Preoperative radiograph shows hypermobile first ray. Postoperative radiograph shows arthrodesis of first metatarsocuneiform. Lateral release sequence: (1) release of conjoined adductor hallucis tendon, (2) release of fibular sesamoid ligament, (3) tenotomy of lateral head of flexor hallucis brevis, and (4) excision of fibular sesamoid. of 29

Question: In the human body, what is a hallux valgus more commonly known as?
Answer: Bunion